BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ULTAMET MTL INS NEUT 36MM 56OD

    MDR report key: 1914022 · Received December 1, 2010

    Report

    Report Number
    1818910-2010-08874
    Event Type
    Injury
    Date Received
    December 1, 2010
    Report Date
    February 27, 2026
    Manufacturer
    DEPUY INTERNATIONAL, LTD.
    Product Code
    KWA
    PMA / PMN Number
    K003523
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER
    Health Professional
    N

    Narratives

    Additional Manufacturer Narrative · 1

    THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

    Description of Event or Problem · 1

    THE PATIENT WAS REVISED DUE TO PAIN AND PSEUDOTUMOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ULTAMET MTL INS NEUT 36MM 56OD 87KWA KWA DEPUY INTERNATIONAL, LTD. NA 2441632

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Required Intervention